It has been a rough week. A very rough week.
Last Friday I took Crash in for some routine arthritis treatment. It should have been an easy day with him hanging out in his cage and getting loved on by all my coworkers. When I pulled him out of his carrier I noticed bloody saliva on the side of his mouth. I asked the doctor to take a look at him when she had a chance. She looked in his mouth and noticed an ulceration. It’s on the right hand side of his mouth, where the gums and the lip meet. She suspects the ulceration is a fast growing cancer called a squamous cell carcinoma (read more about this nasty cancer here and here).
We didn’t know for sure if it was cancer, the only way to find out for sure is a biopsy. Crash is old, almost 20, and has numerous chronic health conditions so there were concerns about putting him under anesthesia. He might not make it through surgery, and if he did, the effects of the drugs could be detrimental to the rest of his body; my particular concern was for another pancreatitis flair up. We did some lab work to see if he was healthy enough to undergo surgery. His labs came back fine, no particular red flags there. I talked with the doctor and we determined there was no “right” or “wrong” answer here. I could do surgery to have the ulceration biopsied and risk anesthesia, or I could leave it alone and find out soon enough if it is indeed cancer. Was it worth it to take the risk on surgery? What if I put him under anesthesia, he didn’t make it and the biopsy comes back negative for cancer?
The thought that I might only have weeks left with Crash was enough to make me want to do surgery. I figured if he did pass while under anesthesia, at least it wouldn’t be painful. Yet, despite that leaning, I just couldn’t decide. So I emailed his doctor and said I wanted to do a cardiac ultrasound. Crash has had a heart murmur and an arrhythmia for a number of years now. The doctor told me that if I was uncertain a cardiac ultrasound (Echo) would be the next step. I couldn’t decide what to do. I spent part of my Goddaughter’s Baptism praying for guidance and I asked the universe to guide me towards the most benevolent outcome. Which is how I ended up doing an Echo.
Though a series of very fortunate events, I was able to get Crash in to see the Cardiologist who was visiting our office on Monday. We did the echo and it certainly made up my mind. He is in heart failure. His prognosis is guarded. He would never survive surgery. We are now just waiting to see which will get him first. Thankfully at least Crash seems to be asymptomatic for both his cancer and his heart failure. I started him on two new heart medications and a lower sodium sub-q fluids on Wednesday. He seems to take to them well enough. If he shows signs of really not wanting to take the new medication we will discontinue it immediately. Everything is about making him comfortable now.
For the first few days after Crash’s grim diagnosis–heart failure and suspected squamous cell oral cancer–I was a wreck. I tried to keep a stiff upper lip at work. There are way too many triggers when you work at a vet’s office and are trying to not think about your ill cat. I continuiously broke down crying. One day I was sitting on the couch crying hysterically when Crash came over, jumped in my lap and made me pet him. I started crying even harder then. I am treasuring every moment; even the 4:30 am paw-across-my-face-’cause-he’s-hungry wake up call.
I realized though, that Crash is no different than he was last week. He’s no different than he was last month, or the month before. He acts exactly the same. He eats as well as he ever does–which is to say many small meals throughout the day, and he never knows what he wants. He still snuggles. He still fights his medication with just enough energy for me to know he feels well (but not enough to know he really hates them.) He hasn’t been highly active in a number of years, so there is no decrease in energy. This has been the biggest help for me. The only thing that has really changed is that I have some idea of a timeline for when Crash might pass. Considering I knew he was nearing the end, this shouldn’t be such a big shock to me. He displays so many of the symptoms of the cancer, but he has displayed those symptoms for months. And they are symptoms for many other diseases that he has. He certainly doesn’t eat like a cat who has a cancerous growth in his mouth.
I know people are judging me for adding new medications. I don’t care. He is my cat and my best friend.I will do anything in the world for this cat. I hope when the time comes I will have the strength to euthanize him before he starts suffering. I realize that the new medications will, at most, only buy him a little bit of time. I don’t care. Crash saved my life when I was depressed. Crash, along with Sam and Muffin, made life bearable when the Depression took hold, but before I knew what was going on with me. He is the last of his litter. When Crash dies, a huge part of me will die with him. I honestly don’t know how I will carry on without him. I know that is why Sneakers came to me…but that is another blog post.
Now, it is all about loving Crash even more than usual. Loving him and appreciating him and enjoying every single moment with this cat. And since he has already assumed his regular position at the left corner of my bed, I guess that means its time for me to go snuggle him.